In order to deal with high uncertainty and variability in emergency medical centers, many researchers have developed various models for their operational planning and scheduling. However, most of the models just provide static plans without any risk measures as their results, and thus the users often lose the opportunity to analyze how much risk the patients have, whether the plan is still implementable or how the plan should be changed when an unexpected event happens. In this study, we construct a simulation model combined with a risk-based planning and scheduling module designed by Simio LLC. In addition to static schedules, it provides possibility of treatment delay for each patient as a risk measure, and updates the schedule to avoid the risk when it is needed. By using the simulation model, the users can experiment various scenarios in operations quickly, and also can make a decision not based on their past experience or intuition but based on scientific estimation of risks even in urgent situations. An example of such an operational decision making process is demonstrated for a real mid-size emergency medical center located in Seoul, Republic of Korea. The model is designed for temporal short-term planning especially, but it can be expanded for long-term planning also with some appropriate adjustments.

The maxillofacial region is susceptible to damage because facial bone is prominent. The aim of this study is to evaluate the incidence, etiology, seasonal distribution, and patterns of maxillofacial injuries and investigate the percentage of bone fractures on CT scans by patient’s gender and age. Electronic medical records of 1,483 patients who had maxillofacial injuries and visited the Emergency Medical Center of Chonnam National Hospital were evaluated. Age, gender, etiology, seasonal occurrence, frequency of fracture, and the pattern of bone fracture were analyzed by using IBM SPSS Statistics 21 (SPSS Inc., Chicago, IL, USA). Male to female ratio was 2.82:1. The most common causes of injury were falls or collisions (male 40.09%, female 48.2%), followed by traffic accidents and violence. The number of injuries related to sporting accidents, assult, and industrial accidents was higher in male patients than that of female patients. With regard to the seasonal occurrence, 434 cases (29.26%) occurred in the summer, while 306 cases (20.63%) occurred in the winter. In this study, 946 patients (63.79%) were identified to have facture and 537 patients (36.21%) were found to be without fracture on CT scans. The orbital bone (41.38%) was the most commonly fractured in the mid facial structures. The most common fracture site in the mandible was the body of the mandible (23.13%). The patterns of maxillofacial injuries were various based on gender, age, cause of injury, and season.

The purpose of this study was to identify vulnerable area of emergency medical care. In the existing method, the emergency medical vulnerable area is set as an area that can not reach the emergency room within 30 minutes. In this study, we set up an area that can not reach within 30 minutes including the accessibility of 119 emergency center. To accomplish this, we obtained information on emergency room and 119 emergency center through Open API and constructed road network using digital map to perform accessibility analysis. As a result, 509 emergency room are located nationwide, 78.0% of them are concentrated in the region, 1,820 emergency center are located, and 61.0% of them are located in rural areas. The average access time from the center of the village to the emergency room was analyzed as 15.3 minutes, and the average access time considering the 119 emergency center was 21.8 minutes, 6.5 minutes more. As a result of considering the accessibility of 119 emergency center, vulnerable areas increased by 2.5 times, vulnerable population increased by 2.0 times, and calculating emergency medical care vulnerable areas, which account for more than 30% of the urban unit population, it was analyzed that it increased from 17 to 34 cities As a further study, it will be necessary to continuously monitor and research the real-time traffic information, medical personnel, medical field, and ambulance information to reflect the reality and to diagnose emergency medical care in the future.